Section 1 Foundations
Sociocultural Influences on the Development of Eating Disorders and Obesity
Linda Smolak and Caitlin Chun-Kennedy
Television, magazines, the Internet, and movies constantly expose people to ideal bodies, with girls and women being portrayed as thin and sexy (Levine & Murnen, 2009) and, somewhat less commonly, men as lean and muscular (McCreary, 2011). Appearance-related teasing is very common (Menzel et al., 2010). Even parents frequently comment on childrens weight and body shape (Abraczinskas, Fisak, & Barnes, 2012; Fisher, Sinton, & Birch, 2009). Given all of these sources of information and perhaps pressure about what ones body should look like, it is not surprising that eating disorder (ED) researchers have investigated sociocultural factors as risk factors for the development of EDs. However, despite the ubiquitous images of ideal bodies, rates of overweight and obesity continue to increase in the United States (Ogden & Carroll, 2010). Thus, some people have wondered whether the cultural ideal has much relevance, raising the possibility that EDs are primarily biological in origin (Strober & Johnson, 2012; Sussman & Klump, 2011). However, even if genetic or neurochemical etiological factors are present in EDs, they certainly interact with environmental factors, including sociocultural influences, to shape the onset and maintenance of the disorders.
EDs, perhaps particularly anorexia nervosa, and obesity may seem like polar opposites. In fact, however, they have much in common. First, at least one form of ED, that is, binge eating disorder, is associated with an increased risk of obesity. Second, EDs and obesity share several risk factors, including body dissatisfaction and dieting, both of which are influenced by sociocultural messages. Indeed, certain sociocultural influences, including teasing about weight and parental comments, predict later overweight status among adolescents (Haines, Neumark-Sztainer, Wall, & Story, 2007; Neumark-Sztainer et al., 2006). Deeply embedded social messages about the importance of being thin and the vilification of fat likely contribute to both problems. Thus, the sociocultural factors discussed in this chapter are relevant to both EDs and obesity.
In this chapter, we review the role of sociocultural influences in the development of body image disturbance and disordered eating, two of the primary risk factors for the development of EDs and obesity (Jacobi, Hayward, deZwaan, Kraemer, & Agras, 2004; Stice, 2002). Disordered eating refers to problematic attitudes and behaviors related to eating such as calorie-restrictive dieting, binge eating, and purging that are potentially dangerous to physical and mental health. Although we briefly discuss macro-level factors such as gender and ethnicity, our focus is media, peers, and parents as sociocultural agents. We also consider personal characteristics, particularly social comparison, thin-ideal internalization, and selfobjectification, as possibly increasing the effect of these sociocultural risk factors. In the final sections of the chapter, we consider the application of the sociocultural risk factor research to counseling practice.